1 Medical Writers Skills Workshop Nancy B. Clark, M.Ed. Director of Medical Informatics Education FSU College of Medicine Fall 2009 All recources are available online at

2 Objectives Attendees will Identify good references Perform a MEDLINE search effectively Find full text journal articles Find info in online textbooks Find online health stats Use EndnoteWeb to manage citations and references in a defined style

3 Tutorials Tutorials at Pubmed (assigned)  Searching PubMed  Using Mesh Terms  My NCBI (optional) Tutorials on Medical Library page  Using EndnoteWeb (4)  Finding e-Journals (3) Tutorials at EndnoteWeb.com

4 Essential Software MSWord 2007 Endnote Web Cite While you Write plugin  Stedman’s Medical Spellchecker

5 Prerequisite Word Skills Headers and footers Page numbers Fonts and sizes Paragraph formatting  Numbering or bullets  Single/double spacing  Hanging indents/first line indents Page Breaks Tables and captions Page layouts Word Document Properly Formatted at

6 Research Paper Research Paper: In the Fall there will be a research paper that should be based on your thoughtful assessment of the readings, lecture material, assimilation with other assignments in other Year 2 classes, and class discussion. Topics for the term paper will be on health policy or patient safety/medical errors. Topics for papers are chosen by students but must be approved by the course director. One possible format for the research paper could be as follows:  Part I, write an opening statement that explains why the issue you have chosen is important;  Part II, provide an overview of the most important arguments and concepts supporting your topic;  Part III, provide your assessment of the strengths and weaknesses of the positions reflected in Part II;  Part IV, draw conclusions about the issue. The body of the paper will be 10 pages (double-spaced). The paper will require the use of “Endnote” and should have both primary and secondary references.

7 Find the References What are the best?

8 Levels of References Primary: Peer Reviewed journal articles Secondary: Not peer reviewed Primary Secondary

9 Levels of Peer Reviewed Information Primary: original research Secondary: review articles Tertiary: textbooks, summaries Primary Secondary Tertiary

10 Clarification for Paper Primary means original research on topic Secondary means everything else No set number of references requires  Quality over quantity  Grade not dependent on number of references

11 Primary Peer Reviewed Literature Original Research

12 Secondary Peer Reviewed Sources

13 Periodical Databases See FSU Databases A-ZFSU Databases A-Z  ERIC (education journals)  Lexis-Nexis Academic Universe (business, government, medical, legal...)  Newspaper Abstracts (25 major newspapers)  PsychINFO (social sciences)  Web of Science (science, social science, arts and literature citations) MEDLINE (medicine)

14 What is MEDLINE? produced by the National Library of Medicine electronic version of Index Medicus, International Nursing Index, International Dental Literature 1966 – present 4,000+ international biomedical journals includes journal articles, reviews, letters, editorials, comments does NOT include books, conference papers, meeting abstracts, theses

15 MEDLINE Fields Author Title Date Type of publication Journal, Volume, Issue Page numbers Abstract Institution MeSH Headings A lot of cataloging numbers Typical Entry

16 What’s a MeSH Heading? "Medical Subject Headings"Medical Subject Headings vocabulary terms from subject analysis of literature indexing journal articles for Index Medicus ® and MEDLINE MEDLINE cataloging books and audiovisuals controlled vocabulary arranged in a hierarchical MeSH Tree Structures updated annually

17 Examples of MeSH Headings Pubmed MeSH Database

18 Where is MEDLINE? Pubmed (NLM) OVID MD Consult Google Scholar Links to  Full text journal articles  Books  EBM databases

19 Type search terms Tutorial Save searches in your custom ‘cubby.’ PubMed MEDLINE Entering PubMed

20 PubMed MEDLINE Preliminary Results Large number of hits. Click on ‘Details’ to show how PubMed translated the search. (You can modify the search by typing in the text box.)

21 Boolean Operators AND OR NOT Parenthesis * quotes “medication errors” AND “quality improvement” NOT (ambulatory OR “nursing home”)

22 Ambulatory Nursing home “medication errors” AND “quality improvement” NOT (ambulatory OR “nursing home”) Medication errorsQuality improvement

23 PubMed MEDLINE Limit Results Click on ‘Limits’ Limits added in this search: - Indexed in the last 2 years - Human subjects

24 PubMed MEDLINE Refined Results Number of hits is still quite large. (361 from previous 92,441) Add ‘AND diet therapy’ to the search terms. (AND, OR, & NOT operators must be in all capitals.)

25 PubMed MEDLINE Use History #2 AND #3 Click on number of hits to see results Combining Searches

26 PubMed MEDLINE Getting the articles Select ‘Abstract’ view and click on ‘Display’ Click on FSU icon to link to full text.

27 AbstractPlus View Related Articles Link to full text FSU subscriptions

28

29 Tricks Find one good article Look at MeSH headings in MEDLINE view Pick similar articles Search same MeSH terms Use Related Articles in PubMed

30 Too Many Hits: Increase Specificity Use more specific terms in free text search Use mesh search rather than text word search Combine searches Use more specific mesh headings Add terms (using AND) Limit  language of article  human or animal subjects  publication types (e.g. randomized controlled trials, reviews, etc.)  country  year of publication

31 Too Few Hits Increase Sensitivity Find more search terms from good articles Try different combinations of terms Use truncation (*) in Text word OR Subject (ie immunoglob* ) Use OR to add and combine terms Use combination of Text word and Subject searches Select All Subheadings with Subject MeSH terms Search further back in time

32 Find Good Articles Recent Applicable Relevant Good research criteria Not just first full text article you find

33 PubMed MEDLINE Getting the articles when there is no FSU icon If there is no FSU icon, there are other options: 1.Check the FSU COM e- journals page. 2.Check the FSU University Library Serials Solutions Page. 3.Check the online library catalog. If in paper, hoof it. 4.Request an Inter-Library Loan (ILL)

34 E-Journals In electronic less than 10 years Each journal different Digitizing old issues slowly

35 Finding Full Text Articles 1.Pubmed Linked to full text? No… 2.E-Journals list from library webpage? Not listed…E-Journals 3.FSU Serial Solutions from library webpage. In electric format? No...FSU Serial Solutions 4.Online Library Catelog. Owned in print? No…Online Library Catelog 5.Interlibrary loans for titles not owned by FSU (link at top of Library Webpage)

36 Recommendation Create folder for articles in My Documents Save PDF of article, Creating a library of articles If no PDF, Print Preview, Copy and paste into Word document and save Add link in Endnote (Later...)

37 Searching Electronic Textbooks WebFeat Book link in PubMed

Librarian Consults Set up an appointment Attend group help sessions Schedule to be announced 38

39 Finding Health Statistics

40 Types of Health Statistics Questions Fact lookups Research Presentations Social and Policy indicators

41 Strategies for Finding Health Stats Google Search Use Portal Start at Internet site Start with book or article

42 Internet Portals of Health Stats Lists of links that provide starting points for browsing or searching  Keyword search in portal vs Google  General idea what you want The National Center for Health Statistics portal: DHHS Gateway to Data and Statistics Health Services Research Information Central (NLM) Health Services Research Information Central

43 Lexis-Nexis Statistical Universe Subscription resource Searches stat data  Subject List  Limit search  Reports or tables nexis.com/statuniv?B1=Connect+to+Statis tical+Universe nexis.com/statuniv?B1=Connect+to+Statis tical+Universe

44 MMWR Morbidity – illness Mortality – death Disease Trends Tables - searchable

45 Health Care Data Healthcare Cost and Utilization Project HCUPnet  Hospital discharges  Ambulatory service  Costs  Amount of care  By diagnosis and procedure  Surveys of hosp, physicians, nursing homes

46 Health Consequences Costs to society, individuals Cost from care Costs of illness Impact on infrastructure HCFA=>CMS Health Accounts

47 State and International Data Floridahealthstat.com - Where Florida Health Data Resides Floridahealthstat.com - Where Florida Health Data Resides KFF State Health Facts Online United Nations Statistics Division World Health Organization Research Tools World Health Organization Research Tools

48 Individual Datasets EMR Billing CDCS Customized data collection tools

49 Citations and References Note: Endnote Web Camtasia Tutorials on Library Tutorials Page

50 Style Guides AMA Style Guide* AMA Style Guide Examples of AMA Citations Other Style Guides What do I mean by Style Guides?  Format required for submitting articles to journal under Research

51 APA Style Now is the time for all good men to come to the aid of their country.(Alpay & Russell, 2002) Four score and seven years ago our forefathers brought forth a new nation conceived in liberty and dedicated to the proposition that all men are created equal.(Balen & Jewesson, 2004) References Alpay, L., & Russell, A. (2002). Information technology training in primary care: the nurses' voice. Comput Inform Nurs, 20(4), Balen, R. M., & Jewesson, P. J. (2004). Pharmacist computer skills and needs assessment survey. J Med Internet Res, 6(1), e11.

52 JAMA Style Now is the time for all good men to come to the aid of their country. 1 Four score and seven years ago our forefathers brought forth a new nation conceived in liberty and dedicated to the proposition that all men are created equal. 2 References 1.Alpay L, Russell A. Information technology training in primary care: the nurses' voice. Comput Inform Nurs. Jul-Aug 2002;20(4): Balen RM, Jewesson PJ. Pharmacist computer skills and needs assessment survey. J Med Internet Res. Mar ;6(1):e11. This is the style to use.

53 Paper Format Margins 1”, top, bottom, left and right 8 ½ X 11 inch white paper Portrait orientation Font:  Normal: Times New Roman, 12 point  Document title, Heading 2 style: Arial, 14 point, bold, italics  Section titles, Heading 3 style: Arial, 13 point, bold  Subsection titles, Times New Roman, 12 point, underlined Download Sample Title Page

54 Recommendation 1.Use Pubmed to find articles 2.Save PDF, Print out, read, keep or pitch, highlight 3.Do web search for government reports… 4.Print out, read, keep or pitch 5.Do eBooks search, etc 6.Find appropriate statistics 7.Other databases (newspapers) 8.Once you have all items to cite printed out…

55 EndnoteWeb Stores your references on the web Runs in Word Manages Citations Creates References Automatically formats JAMA style

56 Now is the time for all good men to come to the aid of their country. (citation) References - Bibliographic citation - Now is the time for all good men to come to the aid of their country. (citation) References - Bibliographic citation - Research Paper Stack of References: Journal articles Book chapters Web sites Monographs Endnote Library of References Word Document

57 First Time You Start Endnote Web Set up Account 3.UserID: 4.Password (must have at least 1 letter, 1 number, 1 symbol)

Start Endnote Web in Word Endnote Web Tool Bar on Ribbon Will ask you to sign in X

59 Use Endnote Web in Word 1.Create an Endnote Library online 2.Add all cited articles, books, websites, etc. to library 3.Set the Format to JAMA 4.As you type, Find and insert citation Pick reference from library 5.Endnote creates the bibliography

Organize Your References Create New Group for this paper 60

61 How to Populate the Library - Options Manually enter references Connect to Pubmed or other database and capture Search Pubmed or other DB and save results then import (see tutorials on Library website) In Google Scholar, WOS or OVID, search and export directly to Endnote Endnote Web References

62 Add Citations to Library Type them in  Book chapters  Newspaper articles  Statistical Reports  Websites Let Endnote Web grab from PubMed, PsychLit, OVID, etc.  Journal articles

63 How to Type in Citation In Endnote Web  Collect Tab  Select New Reference Pick reference type Type in fields Pick Group to save to Click SAVE

What Fields Do You Need to fill in? Look at or print our Examples AMA Citations 64

65 How to Capture References Collect Tab Online Search Pick a source Pubmed [NLM] Connect

66 Perform Search If article known Use Author and Title word Search

67 Perform Search Retrieve Articles found Pick article(s) Add to Group Pick group

68 Cite While You Write In Word 1.Put Cursor on spot 2.Endnote Web Ribbon Find Citation 3.Type author 4.Click Find 5.Click citation of choice 6.Click Insert Insert

Citation and Reference Appear in Word Document 69

Set AMA Style In Endnote Web Ribbon Style: dropdown Find JAMA If not there… Open Bibliography dialog box Pick JAMA under output style 70

71 Export References PowerPoint Reference Slides JAMA format Format > Bibliography Save as RTF Open in Word Copy and paste in PowerPoint

72 Hands on practice Do a few on your own. If you are missing Endnote Web or Stedmans, go by IT office or tell Help Desk and get them installed.